Who Is Nursing Them? Is It Us: Neoliberalism, HIV/AIDS and the Occupational Health and Safety of South African Public Sector Nurses

ABOUT THE BOOK This book explores the impacts of HIV/AIDS and neoliberal globalization on the occupational health of public sector hospital nurses in KwaZulu-Natal, South Africa, where HIV/AIDS prevalence is among the highest in the world. Just before the epidemic took off in the mid-1990s, South Africa achieved independence from apartheid/colonial rule, raising hopes that conditions would improve for the poor. HIV/AIDS, and a turn toward neoliberal policy, hindered this process. The story of South African public sector nurses provides multiple perspectives on the HIV/AIDS epidemic—for a workforce that played a role in the struggle against apartheid, women who deal with the burden of HIV/AIDS care at work and in the community, and a constituency of the new South African democracy that is working on the frontlines of the HIV/AIDS epidemic. Through case studies of three provincial hospitals in KwaZulu-Natal, set against a historical backdrop, this book tells the story of the HIV/AIDS epidemic in the post-apartheid period. Nurses and hospital managers describe significantly different settings—from a historically neglected rural district hospital to a high-tech, high-level care facility operating as a private-public partnership. Despite the disparities, nurses' occupational health dilemmas were largely the same. While neoliberal policies led to disinvestment and privatization that created workplace inequalities among public sector nurses (though all were low paid), stigma and denial about HIV/AIDS consistently hindered workplace health and safety programs. Even so, nurses and public health managers make a strong case about what is needed to support the South African public health system and the people who rely on it. In so doing they point the way toward a labor/work environment approach to a global public health crisis.Intended Audience: Academics in public health, occupational health and safety, labor and nursing history, and public policy; readers interested in the global HIV/AIDS epidemic and health systems development.

Jennifer Zelnick, M.S.W., Sc.D., is an assistant professor of social work at Salem State College. She worked as a social worker and an organizer for the Service Employees International Union and the Federation of Nurses and Health Professionals, AFT, before obtaining a doctoral degree in work environment policy from the University of Massachusetts Lowell. Her research and practice interests include working conditions in health and social service industries, public policy, community organizing, and environmental health. She lives with her husband, Max O'Donnell, and three children, Lula, Maeve, and Liam, in Cambridge, MA.